Monday, August 31, 2009

Ask the Expert - Week 5

Dr. Kathryn Zerbe, professor of psychiatry at Oregon Health and Science University and a longtime expert on eating disorders, recently took readers’ questions on anorexia, bulimia, binge eating and other problems. Here, she responds to one reader’s question about growing up in a household where eating disorders were common.

Question: In recent years, an increasing number of men have been diagnosed with eating disorders, and not just compulsive overeating, but also disorders like anorexia and bulimia that have traditionally been associated with women. (Full disclosure: I am one such man.)

Does this represent men wanting to take on feminine roles, or feeling that they cannot relate at all to traditional, ultra-macho conceptions of masculinity, and want to take on a more “feminine” persona? Does it differ for homosexual and heterosexual men? To what do you attribute the recent rise in these disorders among men?


Dr.. Zerbe responds:

Two large studies have reported that some 10 to 11 percent of patients with an eating disorder are men, though more recent studies report that as many as 30 percent of patients with anorexia or bulimia are male, and as many as 40 percent of binge eaters are men.

Fortunately our society is moving away, albeit slowly, from stereotyping men and women. Hence, like you, more men are admitting to having anorexia, bulimia, binge eating problems and even just a preoccupation with being a particular weight.

Clinicians are learning more about the millions of men who suffer from body image conflicts, compulsive exercise, weight obsession and other accompanying psychiatric problems like obsessive-compulsive disorder and depression that can accompany a bona fide eating disorder. Men also tend to use steroids more than women to develop a desired masculine build, a condition sometimes called “reverse anorexia.”

Participating in sports like wrestling, gymnastics or running can also place certain men at risk of developing an eating disorder. Those in certain occupations, such as flight attendants, members of the armed forces or actors, may also be at increased risk compared to men in the general population.

Although a large study from 2007 found that gay men do appear to have more eating disorders than straight men, these men do not necessarily want to be feminine. Nor do they seem to have trouble with their masculine role, as they define it. They do, however, desire to be attractive to potential partners and believe that being a particular weight and shape is appealing.

There is some research that suggests that gay men with an eating disorder may be more likely to have been the victim of sexual or physical abuse as a child. You and other men should be aware that the same physical consequences that occur in women with eating disorder take their toll on men, too, including osteoporosis and osteopenia (thinning bones).

Take a look at one of these books about eating disorders in men to learn more: “Making Weight: Healing Men’s Conflicts With Food, Weight, Shape and Appearance,” by Arnold Andersen, Leigh Cohn and Tom Holbrook; or “The Invisible Man: A Self-Help Guide for Men With Eating Disorders, Compulsive Exercise and Bigorexia,” by John F. Morga

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